By: Ed Susman

VANCOUVER, BRITISH COLUMBIA, CANADA – Treatment of mild to moderate Alzheimer’s disease with intravenous immunoglobulin resulted in a slowing of progression of the disease over 3 years in a small population of patients, researchers said at the 2012 Alzheimer’s Association International Conference.

Remarkably, 4 of the 16 patients who completed 36 months of treatment experienced no change in 4 domains of treatment while treated with intravenous immunoglobulin 0.4 mg/kg every 2 weeks, said Norman Relkin, MD, Weill Cornell Medical School, New York, New York, at his poster presentation.

“That means these 4 people were as they were when they began treatment,” said Dr. Relkin during a press briefing. “They had a mild stage of the disease; they were forgetful, they had word-finding difficulty and difficulty in expressing things, but they are still pretty much able to function with a little reminding and a little help in a fairly normal way.”

Dr. Relkin reported the results of a phase 2 extension trial that originally included 24 patients with mild to moderate Alzheimer’s disease. The 16 patients who completed the trial included 11 patients who took various doses of intravenous immunoglobulin across the 36-month course of the trial, and 5 patients who began on placebo for 6 months and then were treated with intravenous immunoglobulin in the extended phase of the trial.

The 4 patients who did not progress were all initially randomised to IVIG 0.4g/kg/ every 2 weeks. They were unchanged from their pre-treatment baseline on measures of cognition, daily function, behaviour, global outcome, and caregiver burden after 3 years.

“This is the first study to provide evidence that intravenous immunoglobulin can benefit Alzheimer’s patients for as long as 36 months,” said Dr. Relkin. “Most Alzheimer patients decline measurably in 3 to 6 months if untreated and within 1 year of initiating currently available treatments. Patients who received intravenous immunoglobulin for a full 36 months in this study had less than expected decline.”

Overall, the rate of progression among these patients was about 50% of what was expected, he said. “However I would not make much of those statistics because of the small numbers of patients,” he said. “I emphasise the group that did not change over time.”

Dr. Relkin said that the treatment was generally well-tolerated. “Most of the adverse events that we saw in this trial are expected for intravenous immunoglobulin such as things like rashes, chills, and fever, which are typically short-lived,” he said.

Major side effects for intravenous immunoglobulin relate to it being a viscous solution that can increase risk of clotting.

“We excluded people from this study who had heart attacks or strokes to lower that risk but we still did see some vascular related events,” said Dr. Relkin.

“We have the advantage of 30 years of background on this drug and its safety profile is well known. There was 1 patient who experienced a transient ischemic attack. That person fully recovered but was removed from the trial.”

- MFP Wire Services
- 07-24-2012

PULLMAN, WA — Researchers at Washington State University have found that a compound in garlic is 100 times more effective than two popular antibiotics at fighting the Campylobacter bacterium, one of the most common causes of intestinal illness. Their work was published in the Journal of Antimicrobial Chemotherapy.

The discovery opens the door to new treatments for raw and processed meats and food preparation surfaces.

“This work is very exciting to me because it shows that this compound has the potential to reduce disease-causing bacteria in the environment and in our food supply,” says Dr. Xiaonan Lu, a postdoctoral researcher and lead author of the paper.

“This is the first step in developing or thinking about new intervention strategies,” says Michael Konkel, a co-author who has been researching Campylobacter jejuni for 25 years.

“Campylobacter”, says Konkel, “is simply the most common bacterial cause of food-borne illness in the United States and probably the world.” Some 2.4 million Americans are affected every year, according to the Centers for Disease Control and Prevention, with symptoms including diarrhea, cramping, abdominal pain and fever. The bacteria are also responsible for triggering nearly one-third of the cases of a rare paralyzing disorder known as Guillain-Barré syndrome.

Most infections stem from eating raw or undercooked poultry or foods that have been cross-contaminated via surfaces or utensils used to prepare poultry.

Lu and his colleagues looked at the ability of the garlic-derived compound, diallyl sulfide, to kill the bacterium when it is protected by a slimy biofilm that makes it 1,000 times more resistant to antibiotics than the free floating bacterial cell. They found the compound can easily penetrate the protective biofilm and kill bacterial cells by combining with a sulfur-containing enzyme, subsequently changing the enzyme’s function and effectively shutting down cell metabolism.

The researchers found the diallyl sulfide was as effective as 100 times as much of the antibiotics erythromycin and ciprofloxacin and would often work in a fraction of the time.

Two previous works published last year by Lu and WSU colleagues in Applied and Environmental Microbiology and Analytical Chemistry found diallyl sulfide and other organosulfur compounds effectively kill important foodborne pathogens, such as Listeria monocytogenes and Escherichia coli O157:H7.

Konkel cautions that the recent work is still at the basic stage, well removed from an actual application. While eating garlic is a generally healthy practice, it is unlikely to prevent Campylobacter-related food poisoning. However, “diallyl sulfide may be useful in reducing the levels of the Campylobacter in the environment and to clean industrial food processing equipment, as the bacterium is found in a biofilm in both settings.”

“Diallyl sulfide could make many foods safer to eat”, says Barbara Rasco, a co-author on all three recent papers and Lu’s advisor for his doctorate in food science. “It can be used to clean food preparation surfaces and as a preservative in packaged foods like potato and pasta salads, coleslaw and deli meats”.

“This would not only extend shelf life but it would also reduce the growth of potentially bad bacteria,” she says.

- MFP Wire Services
- 05-09-2012

WASHINGTON, DC — An analysis of more than 1,000 research articles concluded that few health problems are caused by or clearly associated with vaccines. A committee of experts convened by the Institute of Medicine to review the scientific literature on possible adverse effects of vaccines found convincing evidence of 14 health outcomes — including seizures, inflammation of the brain, and fainting — that can be caused by certain vaccines, although these outcomes occur rarely.

It also found indicative though less clear data on associations between specific vaccines and four other effects, such as allergic reactions and temporary joint pain.

In addition, the evidence shows there are no links between immunization and some serious conditions that have raised concerns, including Type 1 diabetes and autism. The data were inadequate to reach conclusions about other suggested adverse effects.

The review will help the U.S. Department of Health and Human Services administer the Vaccine Injury Compensation Program. The Vaccine Injury Compensation Program is committed to using science-based evidence to inform its decisions about vaccine-related adverse effects, and Health and Human Services turned to Institute of Medicine to provide a comprehensive review of study results on eight vaccines covered by the program. The report’s findings will be useful to all stakeholders involved in vaccine compensation decisions, including the Vaccine Injury Compensation Program staff, people filing claims, special masters that rule on vaccine cases, and others.

Convincing evidence shows that the measles-mumps-rubella vaccine can lead to fever-triggered seizures in some individuals, although these effects are almost always without long-term consequences, the report says. The measles-mumps-rubella vaccine also can produce a rare form of brain inflammation in some people with severe immune system deficiencies. In a minority of patients, the varicella vaccine against chickenpox can induce brain swelling, pneumonia, hepatitis, meningitis, shingles, and chickenpox in immunocompromised patients as well as some who apparently have competent immune function, the committee found. The majority of these problems have occurred in individuals with immunodeficiencies, which increase individuals’ susceptibility to the live viruses used in measles-mumps-rubella and varicella. Six vaccines — measles-mumps-rubella, varicella, influenza, hepatitis B, meningococcal, and the tetanus-containing vaccines — can trigger anaphylaxis, an allergic reaction that appears shortly after injection. And, in general, the injection of vaccines can trigger fainting and inflammation of the shoulder, the committee noted.

The evidence suggests that certain vaccines can lead to four other adverse effects, although the data on these links are not as convincing, the report says. The measles-mumps-rubella vaccine appears to trigger short-term joint pain in some women and children. Some people can experience anaphylaxis after receiving the HPV vaccine. And certain influenza vaccines used abroad have resulted in a mild, temporary oculo-respiratory syndrome characterized by conjunctivitis, facial swelling, and mild respiratory symptoms.

The committee’s review also concluded that certain vaccines are not linked to four specific conditions. The measles-mumps-rubella vaccine and diphtheria-tetanus-acellular pertussis do not cause Type 1 diabetes, and the measles-mumps-rubella vaccine does not cause autism, according to the results of several studies. The evidence shows that the flu shot does not cause Bell’s palsy or exacerbate asthma. Suggestions that vaccines can lead to these serious health problems have contributed to parental concerns about immunization for their children.

Establishing a cause-and-effect relationship between an agent and a health outcome requires solid evidence. The committee’s conclusions are based on the strengths and weaknesses of several types of evidence, including biological, clinical, and epidemiological research. In many cases of suggested vaccine-related adverse outcomes, there is too little evidence, or the available evidence offers conflicting results or is otherwise inadequate to draw conclusions.

“With the start of the new school year, it’s time to ensure that children are up to date on their immunizations, making this report’s findings about the safety of these eight vaccines particularly timely,” said committee chair Ellen Wright Clayton, professor of pediatrics and law, and director, Center for Biomedical Ethics and Society, Vanderbilt University, Nashville, Tenn. “The findings should be reassuring to parents that few health problems are clearly connected to immunizations, and these effects occur relatively rarely. And repeated study has made clear that some health problems are not caused by vaccines.”

In accordance with its charge, the committee focused solely on findings about potential risks of immunizations. It did not examine information that would have allowed it to draw conclusions about the ratio of benefits to risks. However, the committee members noted that deaths and disability due to infectious diseases have been dramatically reduced over the last century since the majority of vaccines were developed and brought into widespread use.

The study was sponsored by the U.S. Department of Health and Human Services.

- MFP Wire Services
- 08-27-2011